Forms

New Patient Forms

Click below to download and print our forms
Please contact your previous dentist and have your xrays and records sent or e-mailed to us prior to your dental appointment. Our e-mail is: garciadental@dentistincary.com

Each form will be launched into a new window. Please print, fill out and bring with you on your visit.

New Patients – print and complete all 4 documents
Click here for the Financial Policy PDF
Click here for the Medical History PDF
Click here for the New Patient Registration PDF

NEW! Click here for the ADA Patient Screening Form

Privacy Act
Click here for the Privacy Act PDF (3-pages)

Update 5/18/20: We are slowly re-opening for more than just emergencies with a goal of returning to our normal schedule Monday, June 1, 2020. We have very much missed seeing our patient family!